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Preoperative spinal embolization associated with improved survival after spinal metastasis surgery
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Postoperative complications, neurological deficits and progressive systematic disease are all significantly associated with worse overall survival in patients with spinal metastasis from thyroid cancer, based on results of a recently published study.
Researchers found median overall survival was 15.4 months in the 43 patients they retrospectively who underwent surgery for spinal metastases from thyroid cancer between 1993 and 2010 at University of Texas MD Anderson Cancer Center. The patients underwent intralesional resection of the gross tumor with circumferential decompression of the spinal cord, which was followed by surgical reconstruction of the affected vertebral bodies and stabilization of the spine. The thoracic spine was the most common site for the spine metastasis, which was the metastasis site in 70% of the patients.
The researchers conducted both a univariate and multivariate Cox analysis and found progressive systemic disease at spine surgery (HR 8.98) and postoperative complications (HR 2.86) were associated with worse overall survival. However, preoperative embolization was significantly associated with improved survival (HR .43) based on the multivariate analysis.
Researchers noted the multivariate analysis showed that a preoperative neurological deficit negatively affected survival (HR 3.01).
According to the researchers, surgeons must take prior treatments into account for thyroid cancer patients since the risk of postoperative complications from metastasis surgery is likely increased when a patient undergoes many procedures. In those cases, they noted, preoperative embolization may be useful, but aggressive surgical treatment should be limited. – by Robert Linnehan
Disclosure: Sellin reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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